COPD Caregiving ChallengesSolved

Caregivers for people with chronic obstructive pulmonary disease (COPD) face tough but loving work, helping their family members manage the condition while still allowing them some independence.

“A caregiver can provide the best possible outcomes by educating herself about the disease and keeping tabs on what’s going on,” says Bill Clark, director of Outreach Programs for the COPD foundation, which has offices in Washington, D.C., and Miami, Fla.

Learning how to help can be overwhelming at first. But with education and relatively simple steps, you can keep your loved one as healthy as possible—and ease your burden, too. Here are some common scenarios and how to solve them.

Q: My dad recently moved in, and I’d like to make sure he gets more exercise. Any suggestions?

Exercise strengthens muscle, which leads to easier breathing, says Clark, who himself has an inherited form of COPD. “Strong muscles don’t use up as much oxygen as weaker ones.” A home treadmill is a great way to make exercise accessible. But before buying, talk to your dad’s respiratory therapist about a fitness program to fit his needs, and ask if he should use oxygen or add to his oxygen while exercising. Once you have a doctor’s OK, look for a motorized treadmill that has a padded walking surface with side and front safety bars.

Also make sure it can operate flat, with no incline, and at a speed as low as 0.6 mph. (Some basic models start at 1.0 mph and a slight uphill grade.)Another option: a stationary bike with adjustable resistance that’s easy to get on and off of. Make sure you can place an oxygen tank beside it without hitting the tank with the pedals.

Q: My mom seems to especially have trouble breathing while she eats. How can I help?

“With COPD, lungs expand as air sacs break down,” says Clark. “So, when a person eats, the stomach pushes against the lungs, making it harder to breathe.” Offer Mom smaller meals more often, and avoid bloating foods like raw vegetables (cooked are fine). And suggest drinking water between bites, which forces you to eat slowly and thins mucus so that you can breathe more easily. Clark also suggests limiting sugar, which causes carbon dioxide retention and can result in shortness of breath.

Q: I often hear my spouse coughing in the shower. Should I be worried?

Steamy showers loosen mucus, a good thing for some COPD patients. For others, steam can make it harder to breathe. If your loved one is gasping for breath in the shower, suggest running cooler water and leaving the shower door ajar so steam can escape. Urge her to take her time, perhaps using a shower chair and handheld shower spray. “A long- handled bath brush can make cleaning easier too,” says Clark. If you can, install a bathroom exhaust fan to help eliminate steam.

Q: I’ll soon be a full-time COPD caregiver, but I’m afraid I won’t know the difference between typical symptoms and the warning signs of a serious attack.

“Look for increased coughing, fever, and bright yellow or green mucus, which can be a sign of infection,” Clark says. Consider buying a home pulse oximeter to measure oxygen and pulse rate. Ask your charge’s doctor what numbers to look for, and notify him when they fall outside that range for 24 hours.

Q: How can I make my home more comfortable and safe for relatives with COPD?

Dirty air contains dust, germs and other irritants that can worsen COPD symptoms. To improve home air quality, get your heating/ cooling system’s air ducts cleaned and invest in HEPA (high efficiency particulate air) replaceable filters, says Clark. Look for MERV (minimum efficiency reporting value) ratings in the 5-8 range—the higher the rating, the smaller the particles the filters catch. “To know how often to change them, check regularly to see how much dust they’ve accumulated,” he adds.

Avoid ionic cleaning systems, which put electric ions into the air that increase the number of particles that get into the lungs.